of the continents which surround them, at least as far as we can judge by their affording a climate of that description which seems to be the most desirable; for actual experience will not allow us to be too confident of obtaining success, even from a residence in these. Dr. Domeier informs us, in his very interesting account of the island of Malta, that the thermometer seldom varies here more than 6° in the 24 hours, or stands below 51°, even in the depth of winter; while in Lisbon he has seen ice, and both ice and snow in Naples; besides that, in these two cities, the difference between day and night often amounts to 20°. If an invalid leaves England in the middle of August, the voyage lasts about a month, and is often of itself highly beneficial, that he arrives at Malta in time to be fully prepared to be further benefited by the mild winter: it appears, however, from the more particular account which Dr. Domeier elsewhere gives of the temperature, that it continues throughout October rather higher than is altogether desirable, being seldom below 70° throughout that month; and in a country where there is scarcely any visible foliage, walls occupying universally the place of hedges, this cannot be a matter of perfect indifference.

In Madeira, though the thermometer attached to a building is seldom found below 54°, there are frequently cold winds, snow, or more commonly something intermediate between snow and hail, often falling on the mountains, at the height of 1000 feet above the sea, and at still greater elevations sometimes lying undissolved till July: and this imperfect kind of hail falls occasionally even on the low grounds. The island is probably a more agreeable residence than Malta: but it seems very doubtful whether it possesses any determinate advantage over it with respect to climate; and it is not impossible, that some other islands in its neighbourhood may afford a greater equability of temperature. We have, however, a more established experience of its beneficial effects in pulmonary diseases than of almost any other situation. Dr. Adams says, that, "in cases of tubercular or scrofulous consumption, if the patient does not saunter away his time after you have advised him to leave England, we can with certainty promise a cure." (Med. Phys. Journ. Apr. 1800.) This true English consumption he thinks is not to be found in Madeira, while the catarrhal affection, which somewhat resembles it, though without purulent expectoration, is not uncommon, and may be fatal if neglected or improperly treated. Dr. Gourlay agrees with Dr. Adams, in his report of the general benefit derived from the climate of Madeira, by consumptive persons going to it from colder countries,

to pass the winter in the island, and of the frequency of catarrhal affections among the inhabitants; but he strongly insists that genuine consumption is also very common and very fatal. There can however be little doubt, from the concurrent testimony of the majority of observers, that the climate of Madeira is extremely salubrious, and that consumptions, though they may sometimes occur, are comparatively rare.

In the West Indies, it is agreed by all authors, that consumptive affections are almost unknown, and that scrofula in all its forms is uncommon; while the inhabitants of the West Indies, coming into a colder climate, are peculiarly liable to the attacks of these diseases. Dr. Hunter, however, observes, that notwithstanding this exemption in favor of the natives of the West Indies, a residence in this climate appeared to him to be of no manner of advantage to persons who were already affected by incipient consumptions when they arrived there. We cannot doubt the accuracy of this evidence, as far as regards the facts which came immediately under Dr. Hunter's observation; they principally related to the military, who perhaps labored under some peculiar disadvantages: but other practitioners have given much more favorable reports of the events of cases, in which they have

made trial of the effect of a residence in this climate; and if we may be allowed to draw any inference from the qualities. of a climate, as indicated either by the thermometer, or by its effects on the constitutions of the inhabitants, there can be little doubt that a residence in Bermudas, in a temperate and sheltered part of Jamaica, or in some other of the West-India islands, together with the equable qualities of the sea air, to which the patient must be exposed during the voyage, must present every advantage towards the recovery of a consump tive person, that climate alone can possibly bestow.

In other diseases, the effects of climate are perhaps less exclusively beneficial; although it appears that gouty persons often derive considerable benefit from a residence in the hottest countries, as in the East Indies, or at Ceylon in particular.. Dr. Gregory seems to be persuaded that life may be lengthened, and the inconveniences of old age retarded or mitigated, by repeated emigrations into warmer and warmer climates, after the age of 50 or 60, according to circumstances: and he thinks that even posterity may be benefited by an emigration of this kind.

In whatever situation the residence of an invalid may be fixed, it is of no small importance that the aspect and exposure of the house, which he occupies, should be selected with a view to the qualities of climate which he is desirous

of obtaining. We have an illustration of the truth of this remark, in an observation recorded by Dr. Carrick, respecting the influenza of 1803. "One of the most open and exposed of the buildings on Clifton-hill is Richmond-terrace, which forms three sides of a parallelogram, fronting respectively the east, south, and west; on the east side, not one family, and scarcely an individual, escaped the complaint; while on the south side, a great majority, both of persons and families, in all other respects similarly circumstanced, escaped it entirely." Such facts as these are among the few which afford solid grounds for medical reasoning; and they deserve the more attention, as they relate to circumstances of continual occurrence, and of perpetual influence on our health and comfort; and in proportion as both the medical and the meteorological sciences become founded on a firmer basis, it cannot be doubted that their beneficial effects will be more and more experienced, as well in the preservation of health, as in the treatment and cure of diseases.

TABLE OF THE ANNUAL MORTALITY

Of the different Counties of Great Britain, according to the

Returns of 1811,

1 in 36 | Berks

45 Suffolk.

53

Lancaster

48

Cumberland

Westmoreland

Hertford

54

54

54

55

Mean of England

49 Oxford

Chester

It is obvious, that those counties which contain large manufacturing towns exhibit a mortality wholly independent of their climate, as is exemplified in the case of Warwickshire; while the natural salubrity of others, for instance, Cornwall, is probably rendered more conspicuous by their exemption from sedentary employments.-Dr. Young's Introduction to Medical Literature.

CRITICAL ANALYSIS

OF RECENT PUBLICATIONS

IN THE

DIFFERENT BRANCHES OF PHYSIC, SURGERY, AND MEDICAL PHILOSOPHY.

A Treatise on the Diseases and Organic Lesions of the Heart and Great Vessels. By J. N. CORVISART, M.D. &c. &c. &c. Translated from the French, by C. H. HEBB, Member of the Royal College of Surgeons in London. 8vo. pp. 404. Underwood and Blacks. 1813.

AS

S the French edition of this work cannot pass through many hands, we congratulate the reading part of the profession on the appearance of this translation, which, as far as we can judge, is faithful. The subject on which this volume treats is of deep importance, yet few writers have attempted it; hitherto, perhaps, the work of Senac may be regarded as the best, although many other authors have described affections of the organ; and recently an excellent treatise has been published by Mr. Burns, which, if not so complete as Corvisart's, contains much valuable information.

The present work is divided into five classes, which com prehend nearly all the diseases to which the heart, its coverings, and appendages, are liable.

The first class comprises the diseases of the membranous coverings of the heart.

The second, diseases of its muscular substance.

The third, diseases of its fibrous or tendinous tissue.

The fourth, of those diseases which, at one and the same time, affect many tissues of the organ, and of those unnatural states which may be considered as so many organic lesions of the heart,

The

The fifth treats of aneurism of the aorta.

In a preliminary discourse of considerable length, the author, with an animation, zeal, and eloquence, worthy of this subject, touches upon the necessity, and advantages of the physician being minutely acquainted with anatomy-not from a barren curiosity to seek out singular appearances in the dead subject; not merely to inform himself of the names, form, and actual situation, of different organs; but to enable himself to distinguish diseases by certain signs, and not doubtful symptoms; always bearing in mind, that "the more minute anatomy is cultivated by physicians, the sooner will they be enabled by just observations to ascertain and prove the existence of a great number of organic lesions, of which most of them had not the slightest suspicion."

To the want of this knowledge combined with that of physiology, the learned author attributes much of that wavering, indecisive practice, and false diagnosis, which physicians often display at the bed-side; some accusing the liver, or the stomach, of derangement, when the complaint was in the chest ; others mistaking a disease of the heart for asthma or dropsy; in short, no organ escaping their misapprehension.

But the physician must not rest content with mere anatomical knowledge, he must make himself master of the secret springs and working of the heart, and penetrate the veil which conceals the philosophy of mind. "Where, (says Corvisart,) may we exclaim, shall we find so clearsighted a physician? No where, I readily admit; but I am not, on that account, the less fully convinced, that one of those qualities on which the tact of a great physician is firmly established, consists in that penetration, incessantly strengthened by exercise, which enables him to perceive in any given patient, the scene of his moral affections, while he observes all the physical phenomena which produce or which result from them."

While we admit the justice of these and other similar remarks of this author, for we cannot insert many of them, we may hint that they are perhaps more applicable to the French school of physic than to our own; though, in these our times, a great change has taken place in the education of physicians in France. Formerly, we find hardly a satirist or novelist who did not make them his especial butt; Boileau, Moliere, Rousseau, and a large fry of smaller writers, had exercised their wit so effectually on this unhappy tribe of men, that ridicule and physic were inseparable. In this country, however, satire has hitherto been very harmless, and has chiefly fallen upon some impudent pretender or hardened empiric. But let us

not